Case Archives

PRESENTING FELLOW

CASE PRESENTATION

A 12 year old girl was referred to the Hospital for Sick Children for lung transplant assessment. She had been diagnosed with cystic fibrosis at ten weeks of age following a history of failure to thrive, and severe left lower lobe pneumonia requiring admission to the Intensive Care Unit.

PRESENTING FELLOW

CASE PRESENTATION

A 2 and 1/2 year old boy with lysinuric protein intolerance presented with recurrent respiratory distress. He was born at term with no perinatal issues but did start to fail to thrive soon after weaning.

PRESENTING FELLOW

Mustafa Osman,

Clinical Fellow, Pediatric Respiratory Medicine
University of Toronto

CASE PRESENTATION

A 2 and 1/2 year old boy with lysinuric protein intolerance presented with recurrent respiratory distress. He was born at term with no perinatal issues but did start to fail to thrive soon after weaning.

PRESENTING FELLOW

CASE PRESENTATION

L.F. is an 8-y-old boy with Dyskeratosis Congenita, diagnosed in 2000. He had a bone marrow transplant from an unrelated donor in 2001 and a history of upper gastrointestinal bleeding April 2005 of unknown etiology. Despite his BMT he suffers from pancytopenia.

PRESENTING FELLOW

Harutai Kamalaporn, MD.

Clinical Fellow, Pediatric Respiratory Medicine,
The Hospital for Sick Children
University of Toronto

CASE PRESENTATION

An 8 year old boy was seen in the Emergency Room with a 5 day history of fever and coughing up blood. At least twice a day he had coughed up "jelly" like clots and his stools were dark. He tired more easily, felt dizzy and also reported his heart was beating harder.

A 9 year old girl presented with a history of hemoptysis 3 times in 2 weeks. She coughed up almost 2 cups of fresh blood through her mouth and nose while sitting in the classroom. She had a repeated episode of bloody coughing again the next day. She was brought to the emergency department in a local hospital and a Chest x- ray was done. "Blood work" and urinalysis examination were unremarkable. A 3rd episode of bleeding then occurred 2 weeks later. Her mother called the emergency medical service and she was brought to the local hospital. Her vital signs were stable without any supplemental oxygen requirement. She was then transferred to the Hospital for Sick Children after initial investigations.

PRESENTING FELLOW

Mustafa Osman

Clinical Fellow, Pediatric Respiratory Medicine
University of Toronto

CASE PRESENTATION

An 8 year old boy was seen in the Emergency Room with a 5 day history of fever and coughing up blood. At least twice a day he had coughed up "jelly" like clots and his stools were dark. He tired more easily, felt dizzy and also reported his heart was beating harder.

Over the last 6 months he had on a few separate occasions brought up blood tinged sputum whilst unwell with upper respiratory tract infections.

PRESENTING FELLOW

CASE PRESENTATION

A 5 year old boy presented to the emergency room complaining of increasing shortness of breath in association with abdominal distention for 4 days. He has trisomy 21 (Down syndrome), and was recently diagnosed to have acute lymphoplastic leukemia (ALL). He was on the induction phase of chemotherapy for the preceding three weeks. He was also "labeled" to have viral induced wheezing episodes with intermittent use of inhaled bronchodilator and corticosteroid.

PRESENTING FELLOW

Marielena DiBartolo

PGY5, Pediatric Respiratory Medicine
University of Calgary

THE CASE

A 13 year-old boy presented to the Emergency room complaining of sore throat, hoarse voice and shortness of breath. He was well until 6 weeks prior to presentation when he developed upper respiratory-like symptoms with sore throat and fever, while on vacation in Mexico. Over the course of the next 6 weeks, he began to complain of a sensation of "throat tightness" and worsening shortness of breath. The shortness of breath initially occurred with exertion, but by the time of presentation, was also present at rest, and associated with 2-pillow orthopnea as well as stridor. Other symptoms during this time included mild fatigue and 5-lbs. of weight loss.

PRESENTING FELLOW

Dr. Joanna E. MacLean, Respiratory Medicine Fellow

Hospital for Sick Children, Toronto, Ontario

THE CASE

This is a previously well 13 year old male who immigrated from Zimbabwe in Jan 2001. He presented with a 1 month history of runny nose & nasal congestion. Two weeks prior to presenting, he developed a cough, which was productive but no haemoptysis. One week prior to presentation he began to vomit with onset of shortness of breath one day prior to presentation. He had an unspecified weight loss, but no fever nor night sweats.

CASE PRESENTATION

PRESENTING FELLOW

Sharon Dell, Paediatric Respiratory Resident

Hospital for Sick Children, Toronto, Ontario

REASON FOR REFERRAL

A 2 year old Canadian girl of East Indian ethnicity presented with a three day history of fever, cough and nasal congestion. She was tachypneic and had a small oxygen requirement. A CXR showed a "ground glass" appearance on the right side and an overall interstitial pattern.

REASON FOR REFERRAL

PRESENTING FELLOW

REASON FOR REFERRAL

XX is a 9 month old female who was well until 3 weeks prior to admission to the Alberta Children's Hospital (ACH). She was diagnosed to have right upper lobe pneumonia . She was treated with oral antibiotics for one week without improvement, and was admitted to her local hospital and treated with intravenous cefuroxime and oral clarithromicin for 2 weeks. There was no improvement in her condition and she was transferred to the ACH.